Assessment of peripheral muscle thickness and architecture in healthy volunteers using hand-held ultrasound devices; a comparison study with standard ultrasound.

BACKGROUND: Pocket-sized ultrasound devices are increasingly used in a variety of clinical situations, and perform well against standard ultrasound machines. We sought to investigate if a pocket-sized ultrasound device can assess muscle thickness and architecture in healthy volunteers. METHODS: Healthy male volunteers (n = 21) across a range of ages were recruited to the study. Laying supine, ultrasound images were taken from the right anterior and lateral thigh. Thickness of the rectus femoris (RFMT), vastus intermedius (VIMT), and the two combined (anterior thigh, AMT) were measured, along with thickness of vastus lateralis (VLMT), pennation angle (VLPA) and derived fascicle length (VLFL). These scans were performed initially using a pocket-sized ultrasound (VScan) and then using a standard device (Telemed Echoblaster 128). RESULTS: In all six variables, there was no significant difference between the two sets of measurements. Intra-class correlation co-efficients (ICC) for VLMT, VLPA, and AMT were all excellent (0.93, 0.89, 0.90 respectively) with the derived value of VLFL having an ICC of 0.84. All ICC values were statistically significant. Regression analysis demonstrated no evidence of proportional bias in any of the measured or derived variables. CONCLUSION: A pocket-sized ultrasound device gives similar measurements of lower limb muscle thickness and architecture as a standard device in healthy volunteers.

Human limb skeletal muscle wasting and architectural remodeling during five to ten days intubation and ventilation in critical care - an observational study using ultrasound.

BACKGROUND: Critically ill patients frequently suffer muscle weakness whilst in critical care. Ultrasound can reliably track loss of muscle size, but also quantifies the arrangement of the muscle fascicles, known as the muscle architecture. We sought to measure both pennation angle and fascicle length, as well as tracking changes in muscle thickness in a population of critically ill patients. METHODS: On days 1, 5 and 10 after admission to critical care, muscle thickness was measured in ventilated critically ill patients using bedside ultrasound. Elbow flexor compartment, medial head of gastrocnemius and vastus lateralis muscle were investigated. In the lower limb, we determined the pennation angle to derive the fascicle length. RESULTS: We recruited and scanned 22 patients on day 1 after admission to critical care, 16 were re-scanned on day 5 and 9 on day 10. We found no changes to the size of the elbow flexor compartment over 10 days of admission. In the gastrocnemius, there were no significant changes to muscle thickness or pennation angle over 5 or 10 days. In the vastus lateralis, we found significant losses in both muscle thickness and pennation angle on day 5, but found that fascicle length is unchanged. Loss of muscle on day 5 was related to decreases in pennation angle. In both lower limb muscles, a positive relationship was observed between the pennation angle on day 1, and the percentage of angle lost by days 5 and 10. DISCUSSION: Muscle loss in critically ill patients preferentially affects the lower limb, possibly due to the lower limb becoming prone to disuse atrophy. Muscle architecture of the thigh changes in the first 5 days of admission, in particular, we have demonstrated a correlation between muscle thickness and pennation angle. It is hypothesised that weakness in the lower limb occurs through loss of force generation via a reduced pennation angle. CONCLUSION: Using ultrasound, we have been able to demonstrate that muscle thickness and architecture of vastus lateralis undergo rapid changes during the early phase of admission to a critical care environment.

Impact of hydrological alterations on river-groundwater exchange and water quality in a semi-arid area: Nueces River, Texas.

There is a lack of understanding and methods for assessing the effects of anthropogenic disruptions, (i.e. river fragmentation due to dam construction) on the extent and degree of groundwater-surface water interaction and geochemical processes affecting the quality of water in semi-arid, coastal catchments. This study applied a novel combination of electrical resistivity tomography (ERT) and elemental and isotope geochemistry in a coastal river disturbed by extended drought and periodic flooding due to the operation of multiple dams. Geochemical analyses show that the saltwater barrier causes an increase in salinity in surface water in the downstream river as a result of limited freshwater inflows, strong evaporation effects on shallow groundwater and mostly stagnant river water, and is not due to saltwater intrusion by tidal flooding. Discharge from bank storage is dominant (~84%) in the downstream fragment and its contribution could increase salinity levels within the hyporheic zone and surface water. When surface water levels go up due to upstream freshwater releases the river temporarily displaces high salinity water trapped in the hyporheic zone to the underlying aquifer. Geochemical modeling shows a higher contribution of distant and deeper groundwater (~40%) in the upstream river and lower discharge from bank storage (~13%) through the hyporheic zone. Recharge from bank storage is a source of high salt to both upstream and downstream portions of the river but its contribution is higher below the dam. Continuous ERT imaging of the river bed complements geochemistry findings and indicate that while lithologically similar, downstream of the dam, the shallow aquifer is affected by salinization while fresher water saturates the aquifer in the upstream fragment. The relative contribution of flows (i.e. surface water releases or groundwater discharge) as related to the river fragmentation control changes of streamwater chemistry and likely impact the interpretation of seasonal trends.

Late Pliocene Homo and hominid land use from Western Olduvai Gorge, Tanzania.

Excavation in the previously little-explored western portion of Olduvai Gorge indicates that hominid land use of the eastern paleobasin extended at least episodically to the west. Finds included a dentally complete Homo maxilla (OH 65) with lower face, Oldowan stone artifacts, and butchery-marked bones dated to be between 1.84 and 1.79 million years old. The hominid shows strong affinities to the KNM ER 1470 cranium from Kenya (Homo rudolfensis), a morphotype previously unrecognized at Olduvai. ER 1470 and OH 65 can be accommodated in the H. habilis holotype, casting doubt on H. rudolfensis as a biologically valid taxon.